Pay special attention to Italy (COVID-19)

Italy has a modern, westernized medical system similar in quality to the United States. The country is quite a bit smaller and less populated than the US, but it’s easy to look there and imagine it could be an example of what may befall us here if we are unable to stave off a massive outbreak of the virus. In my opinion, due to the lack of control over our border and ports of entry, we will be unable to stop the spread. We have already had one case of the virus land in my own county, treated by the hospital that cuts my paycheck. That patient, who was elderly and had multiple serious comorbidities, died, and we are basically in a holding pattern waiting to see if any medical staff were infected. According to trends worldwide, we will have some that are infected, and they will spread it. If not, we will be one of the only, or maybe the only, location in the US with a case of COVID-19 that didn’t result in a larger outbreak. We will see. In a few weeks.

Back to Italy. Tourist sites are closed, schools are closed, stores are closed, streets are empty. More serious than that, is the fact that one region, Lombardy, has been hit so hard that Italian officials have been pulling retired doctors back into the field, and graduating nursing students early in order to get them into the workforce. Italy has extended emergency protocols to the entire nation, effectively putting the entire country into “lockdown”, and a quarter of the Italian population has been quarantined, including tens of millions in Lombardy who require special permission to travel anywhere.

One woman in St. Louis has tested positive for the virus after traveling to Italy.

Imagine in your state that every single school, K-12 and colleges, are closed without a reopen date. Now add to that every major big box store, like Walmart or Target, and at least half of the smaller ones like Dollar General. Add to that most of your local government buildings, like tag offices. And on top of all that, every single bed in every hospital is full, and every ER, and patients are waiting in the halls, lobbies and parking lots. Maybe 15-20% of your police forces and Fire/EMS workers are either sick or quarantined, and 10% of the nurses and doctors as well.

That is what is happening in Lombardy, Italy right now, and it’s probably going to be happening in the rest of the country within a few weeks. On March 8th, Lombardy went from around 5,900 infections to over 7,300 in a single day. In that same day, the number of deaths went from 133 to 336. A modern, westernized society that has at least twice as much control over their borders and ports of entry as we do, is on the brink of having a collapse of their medical system, and this virus really just started it’s worldwide warpath in January.

It is not time to panic, because panicking, by nature, is an irrational response to any stimuli. But while it’s not time to panic, it IS time to take this seriously. No, it does not matter that the flu has killed more people, because this is much more contagious than the flu, and by all accounts it does have a significantly higher mortality rate (3.4% of all cases, but they also include unresolved cases as survivors, despite those cases still being unresolved, which means the death rate is always inaccurately low). No, this is not just the next hysteria like SARS or MERS, which will probably always be a nothing-burger. This is not Ebola, where even a mediocre second world medical system can control the spread (mainly because, mercifully, Ebola kills extremely quickly and burns itself out). This is different. Is this the big “Disease X”, a term the WHO coined a while back? I don’t know, probably not, but only because that is very unlikely. But it’s the closest we’ve come since the Spanish Flu.

In my ER, and I suspect most or all of the others in the country, we have rolled out policies and protocols for treating suspected COVID-19 patients, protocols that are based in preventing spread of the virus. So far, nothing I’ve seen or heard seems likely to work well. We in the US simply do not have the system in place to handle this, and conjuring one up from scratch isn’t really a thing that happens. As Aesop at RR has stated, every ICU in the country is already at 90% capacity on an average day with zero COVID-19 cases. I would add to that most of the hospitals in the US are at 90% capacity on an average day, not just the ICUs.

It’s past time to stock up on things you don’t want to be without. Once you’ve stocked up, take a trip to the woods. Like I said before, they aren’t going to find the virus in your local creek or state forest. As for us, we will be in the mountains next week. Might be the last vacation any of us will be able to take for a while.

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11 Comments

  1. anonymous March 10, 2020 at 06:46

    Sounds like a plan. The calling up of retired and promoting trainees will not stop corona, only help the early infected. The risk of increasing the infected by these ‘newbies’ is substantial – it just takes one person to create the mousetrap fusion model of new infections.

    As nice as a camping trip sounds, I’m not sure this is a good time to be away from your home base. Might return to find your home ransacked by the desperate or opportunistic. But a day in the woods is never wasted and a weekend sounds like an awesome idea..

    • Gray Man March 11, 2020 at 00:04

      As bad as this can get, I don’t think there is anyone anymore desperate or opportunistic from COVID-19 in my rural area than the local methheads right now. At this point, they are still the major threat for me. But everything they might be looking for is going with us anyway. But like I’ve told my family, this may be the last long vacation we can take for the forseeable future. We shall see!

      • NC Scout March 11, 2020 at 08:12

        Meth heads should be near the top of everyone’s threat matrix on a good day. The ones at the very peak should be the opioid addicts. They’re not always recognizable immediately unless you know the signs, and they’re more ruthless in their methods. Anyone who’s seen someone in the depths of a oxy withdrawal knows what I’m talking about. People on crank just want to steal your stuff, pill heads will do a heck of a lot more, then take your stuff.

  2. Greg March 10, 2020 at 12:28

    Am going to throw some stuff at you all that’s a bit heavy, but decernible.

    First, currently they are using the total number of cases to figure death rate…That’s incorrect. You can only figure death rate or cured rate by the Resolved cases. I.E. “Cured or Dead.. I would be in the form of D rate=D/D+C. Currently it’s about 6%. There’s a caveat. Most deaths are elderly and especially those with Hypertension.

    Here is a Georgetown virus tracker, a not yet peer reviewed paper that addresses ACEII, and a CDC inspired news article that suggests stocking up on hypertension meds. Enjoy, and I agree Grey Man, we may as well enjoy ourselves one more time,c uz it’s hunkersville for the foreseeable future.

    https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

    https://www.biorxiv.org/content/10.1101/2020.01.26.919985v1.full

    https://www.newsmax.com/health/health-news/elderly-cdc-groceries-medication/2020/03/09/id/957603/

    P.S. everything I have read and witnessed to this point, suggests the government just can’t wait to pull Unconstitutional martial pograms.

    • Gray Man March 11, 2020 at 00:07

      Yes, they are incorrect to calculate it that way. That’s why I mentioned that they’re using only “resolved cases”.

      I agree with you on the martial law aspect. Governments everywhere are always happy to do it, but in this case, they’re also too scared not to do it (at some point). My own Congressional Representative is under self-imposed quarantine because of exposure, and maybe he exposed Trump himself. Without going into detail on my own political leanings, it appears that the “cloud people” aren’t going to be able to totally insulate themselves from the virus.

  3. Gray Man March 11, 2020 at 00:00

    5

  4. Greg March 11, 2020 at 12:15

    Gray Man, I reread your article and am not seeing where you mentioned “only resolved cases.” Which again, is not what the government is using…someone should have pointed this out at the NIH, CDC, etc., long ago. They know how to calculate it and intentionally lying.

    BTW, I do see where you mention “included unresolved cases.” Did I miss it?

    • Gray Man March 11, 2020 at 15:52

      I just edited. Re-reading what I wrote, I agree it was about as clear as mud. I fixed it.

  5. Greg March 11, 2020 at 17:54

    No worries Gray Man…You folk that do these write ups have a lot on your hands. People are going bat poop crazy. Isn’t that what we share info for? No one person can do it all, I know, I’ve tried to no avail.

    Will say this; “A government that says don’t stock up and use PPE, then shows a begillion pictures of themselves in PPE, really needs to self check.”

  6. […] 20200310 – Pay special attention to Italy (COVID-19) […]

  7. wilson March 21, 2020 at 16:43

    Italian health system is not equivalent to the US system. I lived in Italy, its medical system is socialized, govt run, inefficient, and medical staff have a big case of “I dont give a damn”. Long wait times unless its an emergency, understaffed hospitals, and quality and access are very dependent on location. Health care in southern Italy is much worse than northern Italy. There is no equivalency between the Italian and US health care, US is unquestionably better. Your initial premise in your first sentence is just wrong.

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